Individual provider Active NPI

Todd Daniel Loutzenheiser, MD

  • Anesthesiology Physician
  • Bremerton, WA
National Provider Identifier
1336200823
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD00042662 Issued in WA
Practice address
990 Sylvan Way
Bremerton, WA 98310-2851
Phone
(360) 479-3657
Fax
(360) 373-7616
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD00042662 WA Primary

Addresses

Primary practice location

990 Sylvan Way
Bremerton, WA 98310-2851

Mailing address

990 Sylvan Way
Bremerton, WA 98310-2851
Phone (360) 479-3657

Other identifiers 8

IdentifierTypeStateIssuer
0174829OtherWALABOR AND INDUSTRIES
911577098-15OtherWAKITSAP PHYSICIANS SERVICE
8372112MedicaidWA
013194010OtherWAGROUP HEALTH COOPERATIVE
192575000OtherWAOWCP
LO7098OtherWAREGENCE
911577098OtherWAUNIFORM MEDICAL PLAN
911577098OtherWAPREMERA BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040102000707 WA Practitioner - Anesthesiology 0648179283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Vermont College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Olympic Anesthesia Services, IncGroup PAC ID 4587551064, 38 clinicians

Practice addresses (Care Compare)

1800 NW Myhre Rd
Michael Medical Ctr
Silverdale, WA 98383-7663
Phone (360) 744-6770

2200 NW Myhre Rd
Charles L Salmon MD Medical Center
Silverdale, WA 98383-7681
Phone (360) 830-1101

Hospital & facility affiliations

  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Olympic Anesthesia Services, Inc Anesthesiology CurrentSince Oct 1, 2008 Accepting new patients
Independent Anesthesiologists of Kitsap Co Anesthesiology Past Accepting new patients

Locations

990 Sylvan Way
Bremerton, WA 98310
Phone (360) 479-3654

2613 Wheaton Way
Bremerton, WA 98310
Phone (360) 479-5908

2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 377-3911

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1336200823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 SYLVAN WAY",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983102851",
            "telephone_number": "360-479-3657",
            "fax_number": "360-373-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 SYLVAN WAY",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983102851",
            "telephone_number": "360-479-3657",
            "fax_number": "360-373-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUTZENHEISER",
        "first_name": "TODD",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00042662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0174829",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KITSAP PHYSICIANS SERVICE",
            "identifier": "911577098-15",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8372112",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH COOPERATIVE",
            "identifier": "013194010",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "192575000",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "LO7098",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIFORM MEDICAL PLAN",
            "identifier": "911577098",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "911577098",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.